Virtual Reality-Based TeleRehabilitation System The technology used for physical rehabilitation has languished behind other sectors of medicine, and clinicians have not had effective tools to follow progress of therapy over the course of injury recovery. However, recent improvements in virtual reality and sensor technology now make it possible to develop an effective and inexpensive rehabilitation system that has the potential to dramatically improve rehabilitation outcomes for neurological and musculoskeletal injuries and disorders, while reducing overall rehabilitation costs. In Phase I of this project, Greenleaf Medical and Forterra Systems will evaluate the feasibility of incorporating one or more novel motion-sensor technologies into a Virtual Reality TeleRehabilitation (VRTR) System for treating victims of stroke, traumatic brain injury, and musculoskeletal disorders of the upper extremities. Sensor technologies to be evaluated include 3-axis MEMS rate gyros, 3-axis MEMS accelerometers, 3-axis magnetoresisitve sensors - individually and in combination with each other - and the Nintendo Wii Remote. Signals from these motion sensors attached near the joints of the upper extremity will be used to drive the images of avatars in patient-relevant virtual environments, as the patients performed the prescribed therapeutic exercises. Performance of the various sensor technologies will be assessed by accurate 6-DOF magnetic tracking units, and by comparison to fixed landmarks. Derivation of body-centric position/orientation signals will be based on Euler's Angles and quaternions. Patient-relevant scenarios will be developed on the Forterra- developed On-Line Interactive Virtual Environment (OLIVE) Platform. In Phase II we propose to prototype the VRTR System, and to implement procedures for securely and interactively linking patient-movement data captured by this rehabilitation system to the patient's clinician, creating a fully functional telerehabilitation system. The VRTR System will be designed to: "Encourage patient compliance with exercise regimens by linking exercise protocols to interactive flat- panel VR scenarios that provide motivation and real-time feedback. "Provide timely information to the clinician regarding patient progress and patient compliance with prescribed treatment regimes." Optimize rehabilitation results by accumulating confidential and secure data in an outcomes database incorporating daily patient rehabilitation progress matched to rehabilitation protocol information. The database can be used to generate evidence-based protocols specific to injuries and patient profiles. [unreadable] [unreadable]